全髋关节置换与人工股骨头置换治疗老年股骨颈骨折的疗效比较

目的探讨全髋关节置换与股骨头置换治疗老年股骨颈骨折的疗效。方法收集我院于2007年5月—2012年5月收治的行人工髋关节置换术的老年股骨颈骨折患者48例,其中全髋关节置换术(THA)24例,单纯股骨头置换术(AHR)24例。观察两组围术期情况、髋关节功能及术后并发症等情况。结果 AHR组手术时间、术中及术后出血量、住院时间均显著少于THA组(P<0.05);AHR组并发症发生率为21%(5/24),THA组并发症发生率为12.5%(3/24),但差异无统计学意义(P>0.05);AHR组Harris评分及髋关节活动总范围均小于THA组,下地行走时间晚于THA组(P<0.05)。结论老年股骨颈骨折患者的术式选择应遵循个体化原则,依据适应证选择恰当的术式。

Comparison between total hip arthroplasty and hemiarthroplasty for treatment of femoral neck fractures in old patients

Objective To investigate the efficacy of total hip replacement and femoral head replacement for treatment of elderly femoral neck fractures.Methods Forty-eight elderly patients of femoral neck fractures were treated with artificial hip joint replacement in our hospital from May 2007 to May 2012,including total hip arthroplasty(THA) in 24 cases and femoral head replacement(AHR) in 24 cases.The two groups were observed on the aspects of perioperation,hip function and postoperative complications.Results The operative time,intraoperative and postoperative bleeding,and hospital stay were significantly shorter or less in the AHR group than in the THA group(P < 0.05);the incidence of complications was 21%(5 /24) in the AHR group and 12.5%(3/24) in the THA group,between which the difference was not statistically significant(P > 0.05);the Harris score and the hip joint range of the AHR group were less and the ground walking time of the AHR group was later than that of the THA group(P < 0.05).Conclusion The choice of surgical procedure for elderly patients with femoral neck fractures should be individualized.